Biomedical subjects

S Roopnarinesingh

Publications and source records attributed to S Roopnarinesingh.

At least 19 recordsLinked to original sources

PubMed1995

Diabetes in pregnancy.

OBJECTIVE: To determine whether there is an association between the level of glycemic control and perinatal complications in pregnant diabetic patients. METHODS: Two hundred sixty confirmed cases of pre-existing diabetes, gestational diabetes and impaired glucose tolerance were analyzed to assess risk factors, modality of treatment, level of blood sugar control and effect on perinatal morbidity and mortality. RESULTS: Risk factors for the development of diabetes included age ( > 25 years), East Indian ethnic origin, glycosuria, and a history of diabetes in a first-degree relative. Treatment consisted of diet alone or in combination with soluble insulin. There is a marked increase in perinatal mortality and maternal morbidity if normoglycemia is not maintained. CONCLUSIONS: A greater emphasis must be placed on the detection of diabetes in pregnancy and effective treatment should be instituted as early as possible to achieve normoglycemia if associated complications are to be reduced.

Adolescent↗

PubMed1994

The results of abdominal myomectomy.

A survey of the records of 103 consecutive patients who underwent abdominal myomectomy revealed that menorrhagia and infertility were the commonest presenting complaints. The overall successful pregnancy rate was only 28.2%, but the procedure was corrective in two-thirds of patients with leiomyomata-related infertility. Intra-operative blood loss, post-operative adhesion formation and recurrence of tumour remain major drawbacks of myomectomy.

Adult↗

PubMed1994

An audit of eclampsia.

One hundred and three patients with eclampsia were managed during a period of eleven years. The perinatal mortality rate was 136 per 1000 total births and there were six maternal deaths. The maternal mortality rate was less among eclamptics delivered by Caesarean Section. Liberal use of diazepam and/or magnesium sulphate and early recourse to Caesarean Section were integral in the care of these women.

Adolescent↗

PubMed1993

Risk factors and treatment of endometrial carcinoma.

A twelve-year retrospective study of 54 consecutive cases of endometrial carcinoma revealed that post-menopausal bleeding was the commonest symptom, and the major associated risk factors were obesity and hypertension. Panhysterectomy was the corner-stone of treatment while adjunctive therapy was based on certain prognostic factors and the operator's preference.

Adult↗

PubMed1993

Cold-knife cervical conization.

Forty-six cervical conizations were performed over a ten-year period for diagnostic or therapeutic purposes. Twenty-nine women were under 45 years of age. The most common reason for conization was an abnormal Papanicolaou smear. The overall incidence of neoplasia was 80.4 per cent. The high complication rate of 28.4 per cent emphasizes the need for a less traumatic technique of excisional biopsy.

Adult↗

PubMed1993

Is adolescent pregnancy hazardous?

A study of the pregnancy outcome in 3320 teenagers revealed a low incidence of pre-eclampsia and anaemia and high rates of eclampsia, prematurity and low birthweight. The perinatal loss was 2.2 per cent and there was one maternal death. A comprehensive programme designed to improve antenatal surveillance is recommended for adolescents.

Adolescent↗

PubMed1993

Haemothorax and ascites associated with endometriosis.

A young patient with pleuroperitoneal endometriosis presented with an haemorrhagic pleural effusion. Two years later, she developed massive ascites which resolved after treatment with oral Danazol and Depo-Provera injections.

Adult↗

PubMed1992

Shoulder dystocia: an obstetrical nightmare.

A nine-year review of 103 cases of shoulder dystocia identified obesity, diabetes mellitus and post-datism as important predisposing risk factors. There was a positive correlation with birthweight. Abnormal labour patterns were invariably absent and perinatal outcome was disastrous. The best strategy is to anticipate and avoid this obstetrical emergency.

Adolescent↗

PubMed1992

Peripartum cardiomyopathy and arterial embolism.

A severely pre-eclampic patient developed peripartum cardiomyopathy and bilateral femoral emboli. Medical therapy for cardiac failure was commenced prior to delivery by Caesarean Section. Bilateral femoral embolectomy was performed on the sixth postpartum day.

Adult↗

PubMed1992

Therapeutic alternatives for the hirsute woman.

A retrospective analysis of 21 hirsute women seen at a gynaecological endocrine clinic revealed a high incidence of infertility, menstrual irregularities and abnormal androgen profile. Polycystic ovarian syndrome (PCOS) was the underlying abnormality in the majority of cases. Cyproterone acetate (CPA) with ethinyl oestradiol in a reverse sequential regime was more effective and better tolerated but much more expensive than the combination of spironolactone and the oral contraceptive pill (OCP).

Adolescent↗

PubMed1992

Adolescent triplet pregnancy.

The occurrence of spontaneous triplet pregnancy among teenagers is a rare event. The present communication describes two cases encountered at the Mt. Hope Maternity Hospital since its inception in 1981.

Adolescent↗

PubMed1991

Another look at the effects of advanced maternal age.

The reproductive performance of primigravidae aged 30 years and over was compared with that of a group of younger primigravidae. Other patients were at greater risk for antepartum complications such as pre-eclampsia and uterine fibroids. Induction of labour was undertaken more frequently, and the Caesarean Section rate was higher but there was no worsening of perinatal mortality.

Adult↗

PubMed1991

Perinatal implications for macrosomic babies.

A five-year record review was undertaken for all babies with a diagnosis of foetal macrosomia. The perinatal mortality rate of 23 per 1,000 total births was similar to the overall hospital rate. Neonatal morbidity was significant, and the most important contributory factor to foetal injury was impaction of the shoulders during parturition. In order to avoid this catastrophe, elective abdominal delivery may be prudent if the foetal weight is estimated at greater than 4,500 grams.

Adolescent↗

PubMed1991

Maternal mortality at Mount Hope Women's Hospital, Trinidad.

A ten-year survey of the magnitude and causes of obstetrical deaths at Mount Hope revealed a maternal mortality rate of 33.3 per 100,000 live births. The leading causes of death were the hypertensive disorders, and the most common identifiable factors were inadequate antenatal care and substandard clinical management.

Adolescent↗

PubMed1990

Fetal outcome among obese parturients.

A controlled study of the fetal outcome among 300 obese gravidae revealed a perinatal loss ten times greater than among nonobese mothers. Diabetes mellitus, pre-eclampsia and advanced maternal age overwhelmingly contributed to this difference. However infants of obese grand multiparae were not at additional risk. Considering live infants the 1 min Apgar score was significantly lower in the study group and was confined to those mothers not at the extremes of maternal age, parity and gestational age. There was no difference in Apgar scores among infants delivered by cesarean section. However significantly more infants of obese mothers delivered vaginally were depressed. These results emphasize the need for stricter obstetric care in the elderly obese mother and those with pre-eclampsia and diabetes. The uncomplicated obese parturient appears to be at no additional risk in terms of fetal outcome.

Apgar Score↗

PubMed1990

The efficacy of cervical cerclage.

A retrospective study of the outcome of pregnancy in 187 women with cervical cerclage revealed a three-fold increase in the crude perinatal survival rate. The McDonald and Shirodkar techniques produced comparable results. Mersilene was as effective as black silk. A significant number of pregnancies with cerclage insertion prior to 14 weeks ended in spontaneous abortions. Postcerclage morbidity was minimal, and abdominal delivery was indicated in only four patients for cervical dystocia. The continued use of this procedure, for selected cases, is justified.

Abortion, Spontaneous↗

PubMed1990

Postpartum shock and uterine inversion.

A 21-year-old woman, para 1 + 0, developed profound postpartum shock secondary to acute inversion of the uterus. Fundal re-inversion was achieved by prompt manual replacement of the uterus from below. An aggressive approach to uterine inversion is the keystone of success.

Adult↗

PubMed1990

The epidemiology and management of patients with hydatidiform mole.

The epidemiology, clinical features and method of evacuating the uterus were reviewed in 30 patients with hydatidiform mole. The incidence was greatest in patients with blood group O and among young East Indians. There was no seasonal variation nor was there any progression to choriocarcinoma. Only one partial mole and one invasive mole were encountered. Evacuation was achieved chiefly by suction curettage and concomitant augmentation with a Syntocinon infusion.

Adolescent↗